Sandra (fictional name) went to see a therapist because of her concerns about her husband. She had tried several times to get him to go by himself or with her and he adamantly refused.

Although his work schedule had been slow, he would say, “I have no time and what would it accomplish anyway?”

When she pointed out that she was worried because he seemed unhappy, irritable, and angry a lot, he countered, “Wouldn’t you be if you were in my shoes?” His work had dwindled considerably and it seemed that he had given up. He had also stopped doing many of the things he used to enjoy.

They didn’t see their friends anymore, didn’t talk, and all he did was lie around and complain. He was drinking more and she knew he was smoking pot again even though he had agreed to give up a year ago.

Their arguments often ended with him saying, “Maybe you’d be better off without me.” More than once he suggested that maybe he would be better off dead.

Sandra is not alone and the chances are that her husband is struggling with depression. Men generally have a hard time dealing with the idea of depression. In the depths of depression, people may think there’s no hope for a better life. This hopelessness is part of the condition, not a reality.

Common symptoms of depression include loss of interest in activities, fatigue, changes in appetite, sleep disturbances, negativity, and apathy. But men tend to express those symptoms differently. Men are more likely to become short-tempered, aggressive, and even hostile. They may feel like the world and the people who love them are against them, leading them to avoid talking about their feelings to friends or family. Too often men tend to deny having problems because they are supposed to “be strong.” American culture suggests that expressing emotion is largely a feminine trait. As a result, men who are depressed are more likely to talk about the physical symptoms of their depression, such as feeling tired or having physical complaints rather than symptoms related to emotions. They are more likely to deal with their symptoms by drinking alcohol or abusing drugs in an effort to seek some relief, often justifying their actions because they “deserve to relax a little.”

The problem with this way of “relaxing” is that it only makes the problem worse and can create another problem on top of the original one. First of all alcohol is a depressant and will not only not relieve any of the symptoms, it will in fact make them worse. Yes, a person may feel some relief for a few hours from drinking but none of the situations that led to the desire for relief will have changed and in fact may be worsened as a result.

The same is true for marijuana and sedatives. The main problem with them is that once the brain is under the influence of an outside substance, it blocks the pathway of the natural chemicals the brain relies on to keep a person emotionally balanced and feeling well. In particular when one is under the influence of marijuana, the brain stops the production of dopamine which is a necessary feel-good hormone. Dopamine is a neurotransmitter in the brain involved with movement, motivation, memory, processing emotions, and feeling pleasure or pain. When the pot high wears off, the brain is lacking dopamine and often a person will feel more irritable and lethargic as a result, thereby increasing depressive symptoms.

A recent study (CBS News) on brain chemistry explained why some workers are “go-getters” and others are “slackers.” The study found people who just won’t give up when working may be aided along by extra dopamine in the brain’s motivation centers. Regular use of marijuana has long been associated with mood swings and reduced levels of motivation. When it comes to depression and brain chemistry and depression, alcohol and marijuana are not a good option.

A better option is to incorporate methods that are known to boost the brain chemicals that help us to keep emotionally balanced and feeling well. It may sound too simple but a good diet and regular exercise are the hands-down best anti-depressants on the planet. Almonds, avocados, bananas, low-fat dairy, lima beans, sesame seeds, and pumpkin seeds may all help your body to produce more dopamine. Fresh fruits and vegetables provide the antioxidants that keep the brain functioning well.

Exercise increases blood calcium, which stimulates dopamine production and uptake in your brain. Walking for 30 minutes, swimming or jogging will likely jump-start your dopamine. Very good studies now show that regular, moderately intense exercise can improve symptoms of depression and work as well as some medicines for people with mild to moderate depression. Exercising with a group or a good friend adds social support, another mood booster.

If these methods don’t work there are other options to explore in finding a way to break the hold that depression can have on your life. There are also many new options for medications that can be prescribed by your physician that have been very useful to people. Asking for help does not mean you’ll be pressured to take prescription drugs. And if you do use an antidepressant, it probably won’t be for life.

Another good option is to start talking to someone about some of the stresses that may be contributing to that feeling of hopelessness. Studies have long suggested that “talk” therapy works as well as drugs for mild to moderate depression. Talking can help to vaporize depression by addressing negative thought patterns, addressing feelings and problems as well as relationship troubles.

The reality is most men who take action to lift their depression do get better. In a large study by the National Institute of Mental Health, 70% of people became symptom-free. Positive thinking gradually replaces negative thoughts. Regular fulfilling activities can return and disrupted relationships can be made more satisfying.

Depression is a health problem. Like other problems, there is usually a way toward a better future even for men who find it hard to ask for help.

“Depression is the inability to construct a future.”

Rollo May

Editor’s Note: Dario Lussardi is a licensed psychologist-master, providing consultation and therapeutic services at the Community Counseling Center in Wilmington.